Document Type : Original Articles

Authors

1 a: Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran b: Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

2 Assistant Professor in Physical Therapy, Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences , Mashhad, Iran.

3 Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

4 Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

Abstract

Background: Abdominal muscles are one of the most important componentsthat provide trunk stability. It has been reported that abdominal musclesendurance can be decreased in patients with low back pain. Tests that canbe used for the assessment of abdominal muscles endurance; include supineisometric chest raise (SICR) and supine double straight-leg raise (SDSLR) tests.The aim of this study is to investigate the effects of visual feedback and verbalencouragement on endurance tests of deep abdominal muscles.Methods: In this two-factor mixed design study, a convenient sample of 40asymptomatic (healthy) participants (20 males and females each) aged between20-35 years was selected. Each subject performed the SICR and SDSLR tests under4 conditions: no feedback, visual feedback, verbal encouragement, and combinedvisual feedback and verbal encouragement. The tests were terminated when thesubject was no longer able to maintain a position. Furthermore, each test wasrepeated twice with 5 min interval and the average time was recorded for analysis.Results: Endurance test time was improved significantly when 2 types of feedbackwere given during the tests (P<0.01). However, combined visual feedback andverbal encouragement had superior effect on endurance test time compared tovisual feedback or verbal encouragement alone (P=0.01).Conclusion: The incorporation of verbal encouragement and visual feedback isan important factor in improving holding time during endurance tasks. Thismay have important implications on endurance training and rehabilitationprogrammes of abdominal muscles.

Keywords

  1. Ito T, Shirado O, Suzuki H, Takahashi M, Kaneda K, Strax TE. Lumbar trunk muscle endurance testing: an inexpensive alternative to a machine for evaluation. Archives of physical medicine and rehabilitation. 1996;771:75-9.
  2. Roy SH, De Luca CJ, Casavant DA. Lumbar muscle fatigue and chronic lower back pain. Spine. 1989;14(9):992-1001.
  3. Bezzoli E, Andreotti D, Pianta L, Mascheroni M, Piccinno L, Puricelli L, et al. Motor control exercises of the lumbar-pelvic region improve respiratory function in obese men. A pilot study. Disability and rehabilitation. 2018;40(2):152-8.
  4. Bergmark A. Stability of the lumbar spine. A study in mechanical engineering. Acta orthopaedica Scandinavica Supplementum. 1989;230:1-54.
  5. Richardson C. Therapeutic exercise for spinal segmental stabilization in low back pain : scientific basis and clinical approach. Edinburgh; New York: Churchill Livingstone; 1999.
  6. Pourahmadi MR, Taghipour M, Ebrahimi Takamjani I, Sanjari MA, Mohseni-Bandpei MA, Keshtkar AA. Motor control exercise for symptomatic lumbar disc herniation: protocol for a systematic review and meta-analysis. BMJ open. 2016;6(9):e012426.
  7. Rajabzadeh F, Taghipour M, Pourahmadi MR, Arab AM. Relationship between flexion-rotation test and ultrasound thickness measurement of the abdominal muscles. Journal of back and musculoskeletal rehabilitation. 2016;29(4):643-8.
  8. Taghipour M, Rajabzadeh F, Arab AM. The Relationship Between the Side-Lying Endurance Test and Ultrasound Thickness Measurement for Abdominal Muscles. Jentashapir Journal of Health Research. 2015;6(2).
  9. Hodges PW, Moseley GL. Pain and motor control of the lumbopelvic region: effect and possible mechanisms. J Electromyogr Kinesiol. 2003;13(4):361-70.
  10. Jull GA, Richardson CA. Motor control problems in patients with spinal pain: a new direction for therapeutic exercise. J Manipulative Physiol Ther. 2000;23(2):115-7.
  11. Hodges PW, Richardson CA. Delayed postural contraction of transversus abdominis in low back pain associated with movement of the lower limb. J Spinal Disord. 1998;11(1):46-56.
  12. Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis. Spine. 1996;21(22):2640-50.
  13. Hides JA, Belavy DL, Cassar L, Williams M, Wilson SJ, Richardson CA. Altered response of the anterolateral abdominal muscles to simulated weight-bearing in subjects with low back pain. Eur Spine J. 2009;18(3):410-8.
  14. Ferreira PH, Ferreira ML, Hodges PW. Changes in recruitment of the abdominal muscles in people with low back pain: ultrasound measurement of muscle activity. Spine. 2004;29(22):2560-6.
  15. Ashmen KJ, Swanik CB, Lephart SM. Strength and Flexibility Characteristics of Athletes with Chronic Low Back Pain. J Sport Rehabil 1996;5(4):275-86.
  16. McIntosh G, Wilson L, Affieck M, Hall H. Trunk and lower extremity muscle endurance: normative data for adults. J Rehabil Outcomes Meas. 1998;2(4):20-39.
  17. Moffroid MT. Endurance of trunk muscles in persons with chronic low back pain: assessment, performance, training. J Rehabil Res Dev. 1997;34:440-7.
  18. Brotons-Gil E, Garcia-Vaquero MP, Peco-Gonzalez N, Vera-Garcia FJ. Flexion-rotation trunk test to assess abdominal muscle endurance: reliability, learning effect, and sex differences. J Strength Cond Res. 2013;27(6):1602-8.
  19. Arab AM, Salavati M, Ebrahimi I, Mousavi ME. Sensitivity, specificity and predictive value of the clinical trunk muscle endurance tests in low back pain. Clinical rehabilitation. 2007;21(7):640-7.
  20. Westberg J, author Jason H. Providing constructive feedback: A CIS guidebook for health professions teachers: Center for Instructional Support; 1991.
  21. Campenella B, Mattacola CG, Kimura IF. Effect of visual feedback and verbal encouragement on concentric quadriceps and hamstrings peak torque of males and females. Isokinetics and exercise science. 2000;8(1):1-6.
  22. Belanger A, McComas At. Extent of motor unit activation during effort. Clinical rehabilitation. 1981;51(5):1131-5.
  23. McNair PJ, Depledge J, Brettkelly M, Stanley SN. Verbal encouragement: effects on maximum effort voluntary muscle: action. Brit J Sport Med. 1996;30(3):243-5.
  24. Binboğa E, Tok S, Catikkas F, Guven S, Dane S. The effects of verbal encouragement and conscientiousness on maximal voluntary contraction of the triceps surae muscle in elite athletes. J Sports Sci. 2013;31(9):982-8.
  25. Baltzopoulos V, Williams JG, Brodie DA. Sources of error in isokinetic dynamometry: effects of visual feedback on maximum torque measurements. J Orthop Sports Phys Ther. 1991;13(3):138-42.
  26. Berger RA. Effects of knowledge of isometric strength during performance on recorded strength. Research Quarterly American Association for Health, Physical Education and Recreation. 1967;38(3):507-.
  27. Kellis E, Baltzopoulos V. Resistive eccentric exercise: effects of visual feedback on maximum moment of knee extensors and flexors. J Orthop Sports Phys Ther. 1996;23(2):120-4.
  28. Lukasiewicz WC. Effect of visual feedback and verbal encouragement on eccentric quadriceps and hamstrings peak torque of males and females: Temple University; 1997.
  29. Park H-K, Kim Y-J, Kim T-H. The role of visual feedback in respiratory muscle activation and pulmonary function. Journal of Physical Therapy Science. 2015;27(9):2883-6.
  30. Juodzbaliene V, Darbutas T, Skurvydas A, Brazaitis M. Does the Length of Elbow Flexors and Visual Feedback Have Effect on Accuracy of Isometric Muscle Contraction in Men after Stroke? BioMed Research International. 2016;2016:6.
  31. Hald RD, Bottjen EJ. Effect of visual feedback on maximal and submaximal isokinetic test measurements of normal quadriceps and hamstrings. J Orthop Sports Phys Ther. 1987;9(2):86-93.
  32. Figoni SF, Morris AF. Effects of knowledge of results on reciprocal, isokinetic strength and fatigue. J Orthop Sports Phys Ther. 1984;6(3):190-7.
  33. Johansson CA, Kent BE, Shepard KF. Relationship between verbal command volume and magnitude of muscle contraction. Physical Therapy. 1983;63(8):1260-5.
  34. Scholtes SA, Van Dillen LR. Gender-related differences in prevalence of lumbopelvic region movement impairments in people with low back pain. The Journal of orthopaedic and sports physical therapy. 2007;37(12):744-53.
  35. Moreau CE, Green BN, Johnson CD, Moreau SR. Isometric back extension endurance tests: a review of the literature. J Manipulative Physiol Ther. 2001;24(2):110-22.
  36. del Pozo-Cruz B, Mocholi MH, del Pozo-Cruz J, Parraca JA, Adsuar JC, Gusi N. Reliability and validity of lumbar and abdominal trunk muscle endurance tests in office workers with nonspecific subacute low back pain. Journal of back and musculoskeletal rehabilitation. 2014;27(4):399-408.
  37. Evans N. The effects of visual and verbal feedback on peak torque in college-aged male and female athletes. 2010.
  38. Warren B, Wright K, Ely C, editors. Effect Of Verbal And Visual Feedback On Peak Torque During A Knee Joint Isokinetic Test. ISBS-Conference Proceedings Archive; 2010.
  39. Kanemura N, Kobayashi R, Hosoda M, Minematu A, Sasaki H, Maejima H, et al. Effect of Visual Feedback on Muscle Endurance in Normal Subjects. J Phys Ther Sci. 1999;11(1):25-9.
  40. Ramachandran VS, Brang D, McGeoch PD. Size reduction using Mirror Visual Feedback (MVF) reduces phantom pain. Neurocase. 2009;15(5):357-60.
  41. Merletti R, Farina D. Surface EMG processing: Introduction to the special issue. Biomedical Signal Processing and Control. 2008;3(2):115-7.
  42. Jung M-C, Hallbeck MS. Quantification of the effects of instruction type, verbal encouragement, and visual feedback on static and peak handgrip strength. Int J Ind Ergonom. 2004;34(5):367-74.
  43. Kroemer K, Marras WS. Towards an objective assessment of the “maximal voluntary contraction” component in routine muscle strength measurements. Eur J Appl Physiol Occup Physiol. 1980;45(1):1-9.
  44. Gandevia S, McKenzie D. Activation of human muscles at short muscle lengths during maximal static efforts. J Physiol. 1988;407:599.
  45. Gandevia S, Allen GM, Butler JE, Taylor JL. Supraspinal factors in human muscle fatigue: evidence for suboptimal output from the motor cortex. J Physiol. 1996;490(Pt 2):529.
  46. Rube N, Secher N. Paradoxical influence of encouragement on muscle fatigue. Eur J Appl Physiol Occup Physiol. 1981;46(1):1-7.
  47. Andreacci JL, Lemura LM, Cohen SL, Urbansky EA, Chelland SA, Duvillard SPv. The effects of frequency of encouragement on performance during maximal exercise testing. J Sports Sci. 2002;20(4):345-52.
  48. O'Sullivan A, O'Sullivan K. The effect of combined visual feedback and verbal encouragement on isokinetic concentric performance in healthy females. Isokinetics and exercise science. 2008;16(1):47-53.